Lifetime Cannabis Use and Augmentation Index in Middle-Aged Adults

Cannabis use has been associated with cardiovascular risks, yet its relationship with subclinical vascular markers such as augmentation index (AIx) remains unclear. This study aimed to investigate the association between cannabis use and AIx, stratified by sex, in a middle-aged general population.

We analyzed data from 20,692 participants of the UK Biobank who had available AIx and cannabis use information. Cannabis exposure was categorized by lifetime use (low, moderate, and heavy), recent vs. past use, and frequency. Linear regression models were stratified by sex and adjusted for cardiovascular and sociodemographic covariates, including blood pressure, heart rate, tobacco and alcohol use, comorbidities, and socioeconomic status.

Men exhibited lower AIx than women (19.06% vs. 21.93%), but a higher prevalence of cannabis use (3.58% vs. 1.68% for heavy users and 7.11% vs. 4.25% for everyday consumption in cannabis users). In men, heavy lifetime cannabis use was associated with increased AIx (β = 1.48, 95% CI [0.76; 2.19]), whereas low use was inversely associated (β = -0.79 [-1.30; -0.27]). Daily cannabis use was associated with higher AIx (β = 1.21 [0.15; 2.27]). In women, heavy use was associated with higher Aix (β = 1.31 [0.20; 2.42]); other patterns of cannabis use were not associated with AIx. In the overall population, there was no evidence of differences in the associations by sex.

Heavy cannabis use was associated with increased arterial stiffness as measured by AIx.